Estimates of the effects of physical activity on osteoporosis using multivariable Mendelian randomization analysis

Xu, Fei; Zhang, Q.; Wang, L.-K.; Tang, Qingxin; Sun, Changqing; Deng, Hong‐Wen

doi:10.1007/s00198-020-05786-2

Cited by 10 publications

(8 citation statements)

References 40 publications

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“…However, the corresponding RCTs used particular types of exercise, such as walking 42 , aerobic exercise 43,44 , progressive resistance training 45 and maximal strength training 46 as interventions. While a MR study 41 and two trials 46,47 showed concordant (Figure 4), positive effect of exercise on BMD, we found that the effect of exercise on lipids did not match between MR and RCTs, with MR study 40 reporting null effect and trials generally finding positive effects on HDL-C concentration and negative on LDL-C, total cholesterol and triglycerides blood levels [43][44][45]48 .…”

Section: ) Exposure/interventionmentioning

confidence: 75%

“…We found that overlapping MR and RCT interventions are often not perfectly identical which may impact on the estimated direction of effect. For example, MR exercise exposures are based on genetic variants associated with self-reported physical activity (moderate-to-vigorous and vigorous) 40,41 in studies assessing the effect on both lipids and bone mineral density (BMD). However, the corresponding RCTs used particular types of exercise, such as walking 42 , aerobic exercise 43,44 , progressive resistance training 45 and maximal strength training 46 as interventions.…”

Section: Resultsmentioning

confidence: 99%

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Systematic comparison of Mendelian randomization studies and randomized controlled trials using electronic databases

Sobczyk

Smith

Gaunt

2022

Preprint

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Mendelian Randomization (MR) uses genetic instrumental variables to make causal inferences. Whilst sometimes referred to as "nature's randomized trial", it has distinct assumptions that make comparisons between the results of MR studies with those of actual randomized controlled trials (RCTs) invaluable. To scope the potential for (semi-)-automated triangulation of MR and RCT evidence, we mined ClinicalTrials.Gov, PubMed and EpigraphDB databases and carried out a series of 26 manual literature comparisons among 54 MR and 77 RCT publications. We found that only 11% of completed RCTs identified in ClinicalTrials.Gov submitted their results to the database. Similarly low coverage was revealed for Semantic Medline (SemMedDB) semantic triples derived from MR and RCT publications - 25% and 12%, respectively. Among intervention types that can be mimicked by MR, only trials of pharmaceutical interventions could be automatically matched to MR results due to insufficient annotation with MeSH ontology. A manual survey of the literature highlighted the potential for triangulation across a number of exposure/outcome pairs if these challenges can be addressed. We conclude that careful triangulation of MR with RCT evidence should involve consideration of similarity of phenotypes across study designs, intervention intensity and duration, study population demography and health status, comparator group, intervention goal and quality of evidence.

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Section: ) Exposure/interventionmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

Systematic comparison of Mendelian randomization studies and randomized controlled trials using electronic databases

Sobczyk

Smith

Gaunt

2022

Preprint

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“…Association of physical activity and fracture may be elucidated by the following biological pathways. Physical activity acts as mechanical stimuli that stimulates bone growth and remodeling through the osteocyte response to biomechanical load . Mechanical forces, which were exerted on the bones during physical activity, induce the maintenance or gain of bone mass and drive adaptation of bone structure .…”

Section: Discussionmentioning

confidence: 99%

Exposure to Neighborhood Walkability and Residential Greenness and Incident Fracture

Zhu,

Yang,

et al. 2023

JAMA Netw Open

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ImportanceEmerging studies have suggested that environmental factors are associated with fracture. However, little is known about the association of neighborhood walkability and residential greenness with fracture.ObjectiveTo investigate the association of long-term exposure to walkability and greenness with incident fracture and explore the potential interaction effect.Design, Setting, and ParticipantsThis cohort study recruited participants aged 40 years or older in Ningbo, China from June 2015 to January 2018. Participants were observed for outcomes through February 2023, with data analysis conducted in March 2023.ExposuresNeighborhood walkability was measured by a modified walkability calculation method according to a walk score tool. Residential greenness was assessed by satellite-derived normalized difference vegetation index (NDVI) within a 1000-m buffer.Main Outcomes and MeasuresIncident fracture was ascertained according to International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes via the Yinzhou Health Information System. Cox proportional hazards models were fit, with age as time scale to estimate the associations of walkability and greenness with fracture. Potential effect modification was explored by covariates, as well as the interactive effect of walkability and greenness.ResultsA total of 23 940 participants were included in this study with 13 735 being female (57.4%). The mean (SD) age at baseline was 63.4 (9.4) years. During a follow-up period of 134 638 person-years, 3322 incident fractures were documented. In the full adjusted model, every IQR increment in neighborhood walkability and residential greenness was associated with a hazard ratio (HR) of 0.88 (95% CI, 0.83-0.92) and 0.84 (95% CI, 0.80-0.89), respectively, for fracture. Furthermore, the association of greenness and fracture was greater with an increase in walkability. The HR (Q4 vs Q1) for greenness was 0.62 (95% CI, 0.46-0.82) in neighborhoods with the highest quartile of walkability.Conclusions and RelevanceThis population cohort study suggested that long-term exposure to neighborhood walkability and residential greenness were both associated with lower risk of incident fracture. The benefits of greenness increased in more walkable areas.

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“…Exercise can effectively increase BMD and slow down bone loss especially in middle-aged and older people [ 22 ]. Except for the amount of exercise, the frequency and pattern of exercise are all linked to BMD [ 27 , 28 ]. It has been proposed that exercise can promote bone formation and decrease bone resorption through both genetic and paragenetic pathways [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

The joint effects of physical activity and sleep duration on risk of osteoporosis in Taiwanese adult population: The Taiwan Biobank Study

Chen,

Su,

Liu

et al. 2023

Osteoporos Int

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Summary Most studies investigating the association between physical activity and osteoporosis prevention only focused on specific types of physical activity. This study’s evidence regarding the combined effects or interaction of sleep duration and physical activity. The findings emphasize the role of sleep duration and physical activity in association with osteoporosis. Purpose The associations between physical activity, sleep duration, and prevalent osteoporosis in Taiwanese adults were studied in this cross-sectional study. Methods The Taiwan Biobank enrolled a community-based cohort of ~ 120,000 volunteers (as of April 30, 2020) between 30 and 76 years of age with no history of cancer. Amongst, bone mineral density (BMD) measures by dual-energy X-ray absorptiometry (DXA) were available in 22,402 participants. After excluding individuals who had no complete data of BMI ( n = 23), MET score ( n = 207), T-score ( n = 8,826), and sleep duration ( n = 16), 13,330 subjects were included as the primary cohort. Univariate and multivariable regression analyses were performed to determine the associations between the presence of osteoporosis, physical activity level, sleep duration, and other variables. Results The results showed that after adjustment, subjects with physical activity < 20 METs/week and ≥ 20 METs/week (aOR = 1.017 and 0.767, respectively) were associated with risk of osteoporosis than those with zero MET. The odds of osteoporosis were not significantly lower in subjects who slept for ≥ 8 h/day (aOR = 0.934,p=0.266). In addition, compared to short sleepers with no physical activity, adults with increased physical activity ≥ 20 METs/week and sleep ≥ 8 h/day had a significantly lowest likelihood of osteoporosis (aOR = 0.702). Those with medium physical activity (< 20 METs/week) plus average sleep duration (6.5–8 h/day) did not have significant higher odds of osteoporosis (aOR = 1.129,p=0.151). Conclusion The findings emphasize the joint role of sleep duration and physical activity in association with osteoporosis. Adults with high physical activity plus high sleep hours have the highest BMD and lowest risk of osteoporosis.

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Estimates of the effects of physical activity on osteoporosis using multivariable Mendelian randomization analysis

Cited by 10 publications

References 40 publications

Systematic comparison of Mendelian randomization studies and randomized controlled trials using electronic databases

Systematic comparison of Mendelian randomization studies and randomized controlled trials using electronic databases

Exposure to Neighborhood Walkability and Residential Greenness and Incident Fracture

The joint effects of physical activity and sleep duration on risk of osteoporosis in Taiwanese adult population: The Taiwan Biobank Study

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